- Centene Corporation (Atlanta, GA)
- …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... appropriateness in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall… more
- CVS Health (Frankfort, KY)
- … behavioral health background. **Preferred Qualifications** + 3 years Managed care/ utilization review experience preferred. + Crisis intervention skills and ... skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable in… more
- Commonwealth Care Alliance (Springfield, MA)
- …require intensive care management and care delivery. Within the CIC Program, The Senior Clinician , Behavioral Health (SBHC) serves as a leader for behavioral ... clinical outcomes of assigned patients by impacting acute care utilization , ensuring optimal treatment for behavioral health...episodic or urgent visits to maintain expected productivity. + Review members' quality gaps prior to every visit and… more
- City and County of San Francisco (San Francisco, CA)
- …positions can review your application Under direction, the 2932 Senior Behavioral Health Clinician performs essential duties that include, but are not ... and compliance review . + The 2932 Senior Behavioral Health Clinician performs related duties as...techniques. + Knowledge of clinical methods refers to the utilization of the history, culture, socioeconomic background, and environment… more
- Molina Healthcare (Reno, NV)
- **Job Description** **Job Summary** Provides support for member clinical review processes specific to applied behavioral analysis (ABA) services. Responsible for ... quality and cost-effective member care. **Knowledge/Skills/Abilities** * Assesses applied behavioral analysis (ABA) services for members - ensuring optimum outcomes,… more
- City and County of San Francisco (San Francisco, CA)
- …positions can review your application Under general supervision, the 2930 Behavioral Health Clinician performs essential duties that include, but are not ... of San Francisco continuously accepts applications for all permanent Behavioral Health Clinician 2930 positions. Rather than...Housing and the Department of Public Health can then review your application and contact you directly with details… more
- Molina Healthcare (Henderson, NV)
- **JOB DESCRIPTION** **Job Summary** Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically ... multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. **Required Qualifications** * At least 2… more
- Dartmouth Health (Keene, NH)
- …critical pathways and outcome measurement preferred. Experience in case management, utilization review and discharge planning preferred. Knowledge of JCAHO/NCQA ... Functioning as a member or the Behavioral Health Team, the Master's Level Clinician...is sensitive to patient needs and expectations, promote effective utilization of resources, and support physician practice, while emphasizing… more
- Centene Corporation (Jefferson City, MO)
- …applicable criteria, and analyzing the basis for the appeal + Ensures timely review , processing, and response to appeal in accordance with State, Federal and NCQA ... of NCQA, Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. **License/Certification:** + RN - Registered Nurse… more
- Atlantic Health System (Morristown, NJ)
- …relapse prevention, and self-management strategies. 04. Provides brief, evidence-based behavioral interventions such as behavioral activation, cognitive behavior ... with medical practice team(s) to build effective relationships, promote service utilization , and provides in-service education as needed to support program… more